ADHESIVE CAPSULITIS (ALSO CALLED FROZEN SHOULDER)

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Frozen shoulder is one of the most painful problems a person can have with their shoulder.  In most cases, there is no known reason that it started, but the problem rather quickly results in painful loss of motion.  The lining of the joint becomes intensely inflamed and leads to motion loss, most notably in reaching to the side and reaching behind.  While the cause isn’t known, about 75% of people who get frozen shoulder are women, often with some recent hormonal fluctuations, especially associated with menopause.  About 20% of people presenting with frozen shoulder are men, but they have often had a recent trauma that jarred the shoulder, probably causing some bleeding into the joint that led to the inflammation.  The other group of people prone to develop frozen shoulder are diabetics, possibly because of some degree of neuropathy.

The following arthroscopic photographs from the Boston Shoulder Institute show the difference between the normal appearance of the shoulder on the left and someone with frozen shoulder on the right.

Quite often, if I can evaluate someone within 3 months onset of frozen shoulder, I can reverse the problem with injections of corticosteroids into the shoulder joint and into the subacromial bursa outside the shoulder, followed by 2-3 weeks of physical therapy.  It is important for people to understand that frozen shoulder is a self-limited problem, but that it can take 12-18 months to resolve spontaneously, which is a long time to be miserable with a stiff painful shoulder.  Rarely, arthroscopic treatment to remove the inflamed tissue and release the contracted capsule are needed for successful resolution in a timely manner.

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